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The authors argue that declining legitimacy of the nonprofit sector in American society can be traced to a limited public understanding of nonprofit enterprise. In this article, they explore the nature and correlates of ownership-related expectations in medical care. Data from a new national survey document that most Americans believe that ownership affects medical care. However, about a third of the public does not understand ownership; those who do not have decidedly less favorable attitudes toward nonprofits. Expectations for nonprofits are more positive among those who feel vulnerable to bad outcomes in medical care, but are substantially more negative among minority groups. Using an experimental design incorporated into the survey, the authors demonstrate that having additional information about ownership improves expectations about nonprofit performance but to varying degrees, depending on the content of the explanation, the particular dimension of performance, and the level of prior understanding.The nonprofit sector in the United States is facing a crisis of legitimacy. In the words of one recent review essay, "A serious fault line seems to have opened in the foundation of public trust on which the entire nonprofit edifice rests" Note: We gratefully acknowledge the support of the Atlantic Philanthropies, the Surdna Foundation, and the Rockefeller Brothers Fund in completing the research reported herein. The survey on which a portion of this article is based benefited from the comments of Marsha Rosenthal, Michael Bucavalas, and Mark Morgan. We also thank the staff at the Kaiser Family Foundation for supplying us with the raw data from several of their surveys described in this article.